Revenue Cycle QA Auditor

Role Description

The Revenue Cycle QA Auditor reflects the mission, vision, and values of Ovation Healthcare, adheres to the organization’s Code of Ethics and Corporate Compliance Program, and complies with all relevant policies, procedures, guidelines, and all other regulatory and accreditation standards.

• Responsible for providing quality audit services to evaluate and improve Revenue Cycle performance.
• Ensures that all quality audits are completed accurately, objectively, and in a timely manner.
• Complete all necessary documentation to support audit work.
• Create performance reports for staff, department, and leadership as required.
• Identifies and produces reports for overall quality trends and provides input to Education and Quality Director for training and development.
• Makes recommendations for the development of action plans with trainers, Managers, and/or Team Leads.
• Processes audit disputes, providing thorough and timely feedback to management.
• Manages internal customer relationships and follows issues through to closure.
• Coordinates audit schedule to ensure compliance with quality audit procedures for staff and departments.
• Completes all supporting information and documentation required for individual and departmental reporting.
• Designs and produces reports and individual quality scorecards as required.
• Provides input to the Education and Quality Director for department policies and procedures.
• Consistently communicates quality audit results to appropriate Manager, Team Lead, and/or Staff.
• Ensure compliance with quality sign-off and documentation procedures for Quality Auditors, Department Manager, and Team Lead.
• Assesses and communicates staff development needs to Education, Quality Director, and training team.
• Assists with the development of training material based on trends identified in monthly audits.
• May occasionally assist with the training of staff based on trends identified.

Qualifications

• Minimum five (5) years of general hospital business office billing and collections experience.
• Understands A/R management concepts for CAH/general hospital, and business office operations.
• Expert level billing and/or collections with Medicare, Medicaid, commercial and/or self-pay.
• Medical billing software expertise in (but not limited to): Meditech (MAGIC, Client Server or Expanse), CPSI, Medhost, EPIC, Meditech, Rycan, Emdeon, Change, Relay Health, Trubridge, Athena, etc.
• Excellent written and verbal skills and demonstrates the ability to manage workload and prioritize while multi-tasking in a fast-paced environment.
• Must possess excellent people skills.
• Critical thinking skills.
• Strong computer skills (Word, Excel, PowerPoint).
• Strong leadership, organization, planning, and time management skills.
• Strong ability to grasp new concepts and apply them.
• Strong ability to understand complex workflows and follow procedures.

Requirements

• High School Diploma or GED required, college degree or some college preferred.
• Additional certification/training via CMS MedLearn, HFMA, AHAM, AMA preferred.

Working Conditions and Physical Requirements

• 100% Remote

Travel Requirements

• 0%